Abstract

Vaginal microbicides (currently under development) against STIs and HIV have the potential for providing women the means to protect themselves, possibly without their partners’ knowledge. Since this potential will be fulfilled only if microbicides are used when they become available, it is important to develop an understanding of the full range of product attributes and individual and sociocultural factors likely to affect adoption of microbicides. Knowledge about possible differences among groups at varying degrees of risk of STI/HIV infection is especially needed. Our study uses an integrated qualitative and quantitative methodology to investigate the effects of numerous product attributes and individual and sociocultural factors on the likely use of microbicides. The study includes U.S. adult and teenaged women and men with different risks of infection recruited from an STI clinic and a family planning clinic; and sexually active teenagers from both clinics. We report results from the qualitative phase, which inform the design of the quantitative phase (which includes use of randomly assigned vaginal gel versus suppository, and pre- and post-use surveys). We present: (1) sociodemographic characteristics and STI and contraceptive experience of the study population, using medical record data; (2) data on clinic staff perceptions about the study population and factors affecting their likely use of microbicides; and (3) findings from focus groups and in-depth interviews that illustrate how acceptability decisions are affected by such factors as relationship dynamics, perceptions of risks and consequences of STIs and HIV, situational factors, self-efficacy and product attributes.